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dcr with lester jones tube
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dcr with lester jones tube

i have been diagnosed with a block of the lower canaliculi at 4mm and have been prescribed a surgery to insert a lester jones tube. my only symptom is a watering eye since the last year. i have heard that the surgery has many complications. is it worth it or should i avoid it? i am a 40 yr old woman and have been wearing contact lenses since 25 yrs but now have to wear glasses which i hate. a constantly tearing eye sometimes makes me depressed. help.
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233488_tn?1310696703
You will have to decide whether you want to put up with the tearing and be depressed or have the surgery and take the risk. Life is risky, We take risks of death everytime we get in an automobile.

If you surgery is done by an experienced oculo-plastic surgeon you can reduce the risks as much as possible and if complications occur will be in good hands to deal with them.

JCH III MD
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Avatar_f_tn
i understand completely how you feel.  i have hust has a third lester jones tube fitted 5 months ago, and yet again has been blocked with growing tissue.spent 45 mins  on monday at hospital where the consultant managed to unblock, up to now is great again. I too cannot cope whenthe watering starts as it affects everything i do .
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Avatar_n_tn
I am completely delighted with my decision to have the surgery.  It has made a huge difference in my state of mind.  No more tearing occurs and I am now able to wear my contacts again.  It is not a complicated surgery and I was back to work in three days - bruised yes - but with dry eyes!  I highly recommend it and wish I had made the decision sooner.
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Avatar_f_tn
The best ocuplastic person in the world, for such a procedure, is Nicholas T. Iliff, M.D. at WIlmer Eye Institute (at Johns Hopkins).  He did amazing eye-saving/life-saving surgery on my dear friend when she had an orbital tumor and will do a final surgery for doing a Jones tube implant.  He, essentially, wrote the book on the surgery and how to mitigate its common complications, and he will be frank about the risks and downfall of surgery.  He offered that my friend, based in California, could avoid surgery and a trip to Baltimore by simply having Botox injections to mitigate her incessant and annoying tearing (he also itemized the risk of the Botox injections--ptosis and strabismus), for the rest of her natural life, instead of travelling to Baltimore and having surgery.  He is simply the best.  

Cautionary note:  there are a lot of inept oculoplastic people doing the implant.  Be very discriminating about who does surgery on your eye.  Obviously, my friend's flying to Maryland for surgery should tell you something about how few and competent oculoplastics people there are, and we live in a major metropolis.
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233488_tn?1310696703
I disagree strongly with Giveypup. The over-whelming number of oculoplastic surgeons are very well trained and very competent. The problem is that they deal with things that are very difficult, very serious and a "good" result on some of their procedures result in a 'cure" maybe less than 50% of the time. That compares to 95% pluss of people having cataract/IOL surgery that are "happy".

Dr. Iliff is indeed a well known and highly qualified oculoplastic surgeon but it strain credulity to say he is the best in the world.

JCH III MD
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Clearly, your credulity would not have been strained had I couched my assessment of Dr. Iliff's superlative position in the pantheon of oculoplastic specialists as "there is no better oculpastic specialist in the world."

Dr. Iliff has published, repeatedly, on his customized technique for Jones tube placement, which has dramatically reduced the incidence of negative outcome and side affects (in his hands, alone).  And, as an aside, he saved my friend's eye (and life) when no one else could or would even make the investigative journey of figuring out how to save her eye.  Oculoplastic surgeons were stumped from L.A. to Philadelphia to Iowa to Boston to New York, and with the exception of Dr. Tse (runner-up for world's best oculplastic/orbital tumor specialist) at Bascom-Palmer, no one used the ingenuity, compassion, and perseverance, which Dr. Iliff did.

This is getting far afield, but all surgeons are not created equally, even with superlative training, and I think it important to have a Jones tube procedure with someone who has done a lot of them, with a high success rate.

I'll let Dr. Iliff know that you think so highly of him--trust me, you have to stand at the end of a long, long line.




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Avatar_f_tn
I had a Jones tune surgery 10 months ago and am glad to have made the decision. Some unpleasant side effects I am wondering about- and wonder should I call my surgeon about-1) a yucky smell in the nasal/sinus area, and 2) the tube wiggles out daily and needs a very firm inward pressing to reset every night. Any similar experiences? Comments? thanks in advance for feedback. Glad to have found this site.
Joyce557
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Avatar_m_tn
Hopefully by now you have made a decision re: jones tube surgery, and are well on the way back to a normal, tear-free life.  I had a jones tube inserted in Australia in the early 70's and it has given me almost 35 years of uncomplicated vision.  Among my achievements (with jones tube intact) was almost 10 years of service as a military pilot.
I have had a minor complication recently with the tube becoming blocked and am visiting an ocular plastic surgeon very soon to see what can be done.  I have never regretted my parents decision to have the initial surgery performed, as it has allowed me a great life so far.  Apparently almost 86% of recipients have little or no complications (from medical studies found on the internet) which is an amazing record.  Good luck with the surgery and post-op. Regards PM
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233488_tn?1310696703
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Avatar_n_tn
I just had dcr surgery with silicon tubes. My surgery was 6 days ago and my eye lid is red, swollen and so is my face beneath my eye. How long will it take for this to heal? The tube hanging in my nose is also annoying. I am very upset I even had the surgery right now and would gladly move to a dry climate instead to fix my teary left eye

Signed RedJoy
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Avatar_f_tn
my eyes started tearing five years ago after chemo and never stopped.  i had dcr surgery three times and i still have excessive tearing in my eyes one of tubes came out and there is no  difference from the tearing in the other eye. it has been over a year since my last surgery and am now considering one more surgery.  the tearing is really frustrating and causing me to feel very uncomfortable when in public.  Is this common to have surgey this many times before it is successful  And how should i select the next surgeon i am desperate.
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233488_tn?1310696703
to redjoy55. Discuss with your surgeon.

to dhty: See a oculoplastic surgeon affiliated with a medical school. Find one at www.aao.org. No most people don't require that many operations.

JCH MD

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Avatar_f_tn
I have had Jones tubes placed in my left eye 3 times, and twice in my right.  All the tubes came out.   My Dr. said I had scar tissue that was pushing the tubes out.  The last surgery was 16 months ago and I am having a lot of trouble seeing.  Do you have any suggestions?

***@****
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233488_tn?1310696703
Same advice. Look for an oculoplastic surgeon on the staff of one of the major medical schools.
JCHMD
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